NEUROTECH, LLC (NPI# 1942795190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1942795190 |
Entity Type | Organization |
Organization Name | NEUROTECH, LLC |
Practice Address |
1263 Main St Ste 213 Green Bay WI 54302-1341 |
Mailing Address |
626 W Moreland Blvd Waukesha WI 53188-2433 |
Practice Telephone | 9204892199 |
Mailing Telephone | 2628756572 |
Enumeration Date | 2018-06-28 |
Last Update Date | 2019-03-09 |
Authorized Official Name | KRISTINE LISA WILDNER (DIRECTOR OF CONTRACTING & RESEARCH) |
Authorized Official Telephone | 2628756572 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | Suppliers | ||
N | 246ZE0500X |
Specialist/Technologist, Other Specialization: EEG |
Technologists, Technicians & Other Technical Service Providers | ||
N | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
Ambulatory Health Care Facilities | ||
Y | 293D00000X | Physiological Laboratory | Laboratories |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912560772 | Neurotech, LLC | Specialist/Technologist, Other | 117 Ne Trilein Dr Ste 202, Ankeny, IA 50021-2082 | 2019-04-17 |
1245793447 | Neurotech, LLC | Specialist/Technologist, Other | 90 Court St Ste 211b, Middletown, CT 06457-3334 | 2019-04-13 |
1194283341 | Neurotech, LLC | Technician, Other | 1440 Rockside Rd Ste 315, Parma, OH 44134-2749 | 2019-03-06 |
1194289603 | Neurotech, LLC | Technician, Other | 2120 44th St Se Ste 202, Kentwood, MI 49508-5321 | 2019-01-29 |
1811451925 | Neurotech, LLC | Technician, Other | 520 Grand Central Ave Unit 204-b, Vienna, WV 26105-2187 | 2019-01-23 |
1891259065 | Neurotech, LLC | Specialist/Technologist, Other | 1691 Town Center St, Aurora, IL 60504-4590 | 2019-01-22 |
1265903710 | Neurotech, LLC | Technician, Other | 2255 W Laskey Rd Ste A-2, Toledo, OH 43613-3573 | 2018-12-10 |
1447735451 | Neurotech, LLC | Specialist/Technologist, Other | 1820 Ridge Rd Ste 303a, Homewood, IL 60430-1759 | 2018-09-26 |
1649763756 | Neurotech, LLC | Specialist/Technologist, Other | 1691 Town Center St Ste 105, Aurora, IL 60504-4589 | 2018-06-13 |
1679064638 | Neurotech, LLC | Clinic/Center | 4609 Mill Branch Ln, Knoxville, TN 37938-3260 | 2018-05-25 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Connecticut Business Registrations | Neurotech, LLC | 626 W. Moreland Blvd, Waukesha, WI 53188 |
System for Award Management (SAM) Entities | NEUROTECH, LLC | 626 W Moreland Blvd, Waukesha, WI 53188-2433 |
Washington State Corporations | NEUROTECH, LLC | 2510 N Pines Rd, Suite 5, Spokane Vly, WA 99206-7636 |
Street Address |
1263 MAIN ST STE 213 |
City | GREEN BAY |
State | WI |
Zip Code | 54302-1341 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336780717 | Neurotech, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1263 Main St Ste 213, Green Bay, WI 54302-1341 | 2019-10-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659721371 | Carissa Marie Sawicki | Counselor | 1234 Main Street, Suite 21, 3rd Floor, Green Bay, WI 54302 | 2016-06-14 |
1891181459 | Shannon Rae Mullins | Registered Nurse | 2254 Imperial Ln, Green Bay, WI 54302 | 2015-04-10 |
1346667045 | David Howard Jadin | Dentist | 1245 Main St, Green Bay, WI 54302 | 2014-03-20 |
1407003577 | Abby Baumgart | Counselor | 1234-21 Main St, Green Bay, WI 54302 | 2008-08-20 |
1447441779 | Muller Eyecare Associates Ltd | Optometrist | 1776 E Mason St, Green Bay, WI 54302 | 2007-08-01 |
1851385231 | Bornemann Nursing Home Inc | Skilled Nursing Facility | 226 Bornemann St, Green Bay, WI 54302 | 2005-08-31 |
1194188706 | Familia Dental Green Bay LLC | Dentist | 1931 Main St., Green Bay, WI 54302 | 2016-03-31 |
1255710125 | Kim Lawrence | Social Worker | 1234 Main St., St 21, 3rd Floor, Green Bay, WI 54302 | 2015-05-26 |
1255464533 | John Muller | Optometrist | 1776 E Mason St, Green Bay, WI 54302 | 2007-03-14 |
1851622005 | Michael Andrew Larkey | Social Worker | 815 Reber St, Green Bay, WI 54302-1116 | 2010-01-27 |
Find all providers in zip 54302 |
Taxonomy Code | 293D00000X |
Grouping | Laboratories |
Classification | Physiological Laboratory |
A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255798815 | Braincare, LLC | Physiological Laboratory | S75w17311 Janesville Rd, Muskego, WI 53150-9376 | 2016-01-26 |
1982945010 | Heart To Sole Diagnostics | Physiological Laboratory | 7635 West Bluemound Road, Suite 1c, Milwaukee, WI 53213-3500 | 2013-03-14 |
1629269899 | T.d.c. | Physiological Laboratory | 3000 Emery Dr, Wausau, WI 54401-9710 | 2007-08-05 |
1902041502 | Mds Digital Portable X-ray Inc | Physiological Laboratory | 10300 W Lincoln Ave, Suite. Ll, West Allis, WI 53227-2100 | 2008-12-10 |
1407868334 | Fox Valley Hematology & Oncology, S.c. | Physiological Laboratory | 3925 N Gateway Dr, Appleton, WI 54913-7863 | 2006-08-12 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.